离断式肾盂成形术治疗肾盂输尿管连接部狭窄的临床效果分析  

Analysis of the clinical effect of discontinuous pyeloplasty in the treatment of ureteropelvic junction stenosis

作　　者：袁晓光 王作江 刘建军 韩铁 Yuan Xiaoguang;Wang Zuojiang;Liu Jianjun;Han Tie(Department of Urology,Yingkou Central Hospital,Yingkou,Liaoning,115001,China)

机构地区：[1]营口市中心医院泌尿外科,辽宁营口115001

出　　处：《当代医学》2020年第33期60-62,共3页Contemporary Medicine

摘　　要：目的探讨离断式肾盂成形术治疗肾盂输尿管连接部狭窄的临床效果。方法选取本院2015年1月至2018年12月收治的80例肾盂输尿管连接部狭窄患者作为研究对象,按照随机数字表法分组,每组40例。对照组实施开放性离断式肾盂成形术,观察组实施后腹腔镜离断式肾盂成形术,比较两组手术情况、术后并发症、术后恢复时间、术后疼痛评分、炎症因子水平、免疫功能指标、生活质量评分。结果观察组手术时间短于对照组,术中出血量少于对照组,差异均有统计学意义(P<0.05)。观察组术后并发症总发生率为2.50%,低于对照组的15.00%(P<0.05)。两组胃肠功能恢复、首次进食、住院时间比较差异有统计学意义(P<0.05)。术后第2~5天,观察组的疼痛评分低于对照组(P<0.05)。术后第1~3天,观察组的C反应蛋白、白细胞介素-6水平均低于对照组(P<0.05)。手术后,两组的CD3^+、CD4^+/CD8^+与手术前相比明显降低,而观察组的CD3^+、CD4^+/CD8^+明显高于对照组(P<0.05)。术后1周,观察组生活质量评分高于对照组(P<0.05)。结论相比于开放性离断式肾盂成形术,后腹腔镜离断式肾盂成形术治疗肾盂输尿管连接部狭窄可减轻患者的手术创伤,具有微创性。Objective To explore the clinical effect of dissecting pyeloplasty in the treatment of stenosis of the ureteropelvic junction.Methods A total of 80 patients with renal pelvic ureteral junction stenosis admitted to our hospital from January 2015 to December 2018 were selected as the study subjects,and they were grouped according to the random number table method,with 40 cases in each group.The control group underwent open disjunctive pyeloplasty,and the observation group underwent retroperitoneal laparoscopic dissected pyeloplasty.The operation conditions,postoperative complications,postoperative recovery time,postoperative pain score,inflammatory factor levels,Immune function index,quality of life score were compared between two groups.Results The operation time of the observation group was shorter than that of the control group,and the intraoperative blood loss was less than that of the control group.The differences were statistically significant(P<0.05).The total incidence of postoperative complications in the observation group was 2.50%,which was lower than 15.00%in the control group(P<0.05).There were statistically significant differences in the recovery of gastrointestinal function,first meal,and hospital stay between the two groups(P<0.05).On the 2nd to 5th day after operation,the pain score of the observation group was lower than that of the control group(P<0.05).On the 1st to 3rd day after operation,the levels of C-reactive protein and interleukin-6 in the observation group were lower than those in the control group(P<0.05).After the operation,the CD3^+ and CD4^+/CD8^+ of the two groups were significantly lower than those before the operation,while the CD3^+ and CD4^+/CD8^+ of the observation group were significantly higher than those of the control group(P<0.05).One week after operation,the quality of life score of the observation group was higher than that of the control group(P<0.05).Conclusion Compared with open dissected pyeloplasty,retroperitoneal dissected pyeloplasty for the treatment of renal pel

关 键 词：肾盂输尿管连接部狭窄 离断式肾盂成形术 后腹腔镜 

分 类 号：R699[医药卫生—泌尿科学]